Excision of intracardiac tumor, resection with cardiopulmonary bypass
CPT4 code
Name of the Procedure:
Excision of Intracardiac Tumor, Resection with Cardiopulmonary Bypass
Summary
In layman's terms, this procedure involves surgically removing a tumor from inside the heart while using a heart-lung machine (cardiopulmonary bypass) to take over the function of the heart and lungs during the operation.
Purpose
This procedure addresses the presence of a tumor within the heart that could interfere with heart function, cause symptoms, or potentially be malignant. The goals are to completely remove the tumor, alleviate symptoms, prevent complications, and potentially treat or stage the cancer if the tumor is malignant.
Indications
- Detection of a mass within the heart via imaging studies like echocardiograms, MRIs, or CT scans.
- Symptoms such as chest pain, shortness of breath, palpitations, or fainting that are linked to the intracardiac tumor.
- Risk of tumor-related complications like obstruction of blood flow or embolization.
Preparation
- Patients may need to fast for several hours before surgery.
- Medications may need to be adjusted, particularly blood thinners.
- Preoperative assessments typically include a thorough cardiac evaluation, imaging studies, blood tests, and consultations with the surgical and anesthesia teams.
Procedure Description
- The patient is placed under general anesthesia.
- The surgeon makes an incision in the chest (sternotomy) to access the heart.
- Cardiopulmonary bypass is initiated by connecting the patient to a heart-lung machine.
- The heart is stopped temporarily while the surgeon locates and excises the tumor.
- The tumor is carefully removed, and the area is closed and checked for any signs of bleeding or complications.
- The heart is then restarted, and the patient is gradually weaned off the bypass machine.
- The chest incision is closed, and the patient is moved to recovery.
Tools and equipment include scalpel, sutures, heart-lung machine, surgical retractors, and various cardiac monitoring devices.
Duration
The procedure typically takes several hours, depending on the complexity of the tumor and the patient's condition.
Setting
This procedure is performed in a hospital's operating room, specifically equipped for cardiac surgery.
Personnel
- Cardiac surgeon
- Assistant surgeons
- Anesthesiologist
- Perfusionist (operates the heart-lung machine)
- Surgical nurses and technicians
- Cardiac monitoring staff
Risks and Complications
- Common risks: Infection, bleeding, reaction to anesthesia.
- Rare risks: Stroke, heart attack, damage to heart structures, complications related to cardiopulmonary bypass.
- Management includes vigilant monitoring, medications, and sometimes further surgical interventions.
Benefits
- Effective removal of the tumor.
- Relief from symptoms caused by the tumor.
- Prevention of future complications related to the tumor's presence.
- Benefits are usually realized immediately or within a short period after recovery.
Recovery
- Patients typically spend several days in the hospital, starting in the Intensive Care Unit (ICU).
- Postoperative care includes pain management, wound care, and gradual resumption of normal activities.
- Full recovery can take several weeks to months, during which time activity levels may be restricted.
- Follow-up appointments are essential for monitoring recovery and heart function.
Alternatives
- Non-surgical management: Monitoring, medications to manage symptoms.
- Minimally invasive approaches: Depends on tumor type and location.
- The pros of surgery include definitive treatment and immediate relief; cons include the risks associated with open-heart surgery and longer recovery time.
Patient Experience
- During the procedure, the patient will be under general anesthesia and will not feel anything.
- Post-procedure, patients may feel pain and discomfort at the incision site, which can be managed with medications.
- The experience involves initial bed rest, gradually moving to light activity, and adherence to recovery guidelines provided by the healthcare team.